title: First case of transformation for breast fibroadenoma to high-grade malignant phyllodes tumor in an in vitro fertilization patient: misdiagnosis of recurrence, treatment and review of the literature.
abstract: BACKGROUND
  Cystosarcoma phyllodes are very rare tumors and may be difficult to diagnose clinically.
  
  
  BACKGROUND
  Fibroadenomas have long been considered benign hyperplastic lesions rather than true neoplastic processes. However, previous clonality studies have shown differing results.
  
  
  OBJECTIVE
  to assess diagnostic and treatment options for phyllodes tumor.
  
  
  METHODS
  A 41-year-old female patient undergoing assisted fertilization treatment. The patient underwent fine needle aspiration biopsy that confirmed fibroadenoma before the IVF attempt. At 17 weeks of gestation, due to an increase in volume of the fibroadenoma, an excisional biopsy was performer that showed a malignant phyllodes tumor. Then she underwent quadrantectomy and chemiotherapy After 1 year there was a recurrence of phyllodes tumors and she underwent mastectomy and chemotherapy.
  
  
  RESULTS
  Fibroadenoma that was transformed into high-grade malignant cystosarcoma after ovarian stimulation, relapsed after one year and it was not immediately diagnosed. The patient underwent mastectomy and chemotherapy.
  
  
  CONCLUSIONS
  it is difficult to diagnose recurrence and to determine tele frequency and the right treatment for such a rare cancer, so it is important to report any case in the literature.
  
  
  CONCLUSIONS
  We recommend to remove a fibroadenoma before attempting IVF for the risk of malignant transformation.
authors.affiliation: Department of Obstetric Gynecological and Urological Sciences, "Sapienza" University of Rome, Rome, Italy. arypac@gmail.com  
authors.forename: A
authors.initials: A
authors.lastname: Pacchiarotti
authors.forename: H
authors.initials: H
authors.lastname: Selman
authors.forename: V
authors.initials: V
authors.lastname: Gentile
authors.forename: A
authors.initials: A
authors.lastname: Pacchiarotti
authors.forename: G N
authors.initials: GN
authors.lastname: Milazzo
authors.forename: G
authors.initials: G
authors.lastname: Lanzilotti
authors.forename: S
authors.initials: S
authors.lastname: Lofino
authors.forename: P
authors.initials: P
authors.lastname: Frati
mesh_terms: D000328:Adult; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000473:pathology*; D002471:Cell Transformation, Neoplastic; D003951:Diagnostic Errors; D005260:Female; D005307:Fertilization in Vitro; D018226:Fibroadenoma / Q000473:pathology*; D006801:Humans; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D003557:Phyllodes Tumor / Q000473:pathology*